Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103K00000X | Behavior Analyst | 749 | CT |
Y | 102L00000X | Psychologist | 749 | CT |
Y | 103T00000X | Psychologist | 749 | CT |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 749 | CT |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 749 | CT |
N | 103G00000X | Clinical Psychologist | 749 | CT |
N | 103TC0700X | Clinical Psychologist | 749 | CT |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 749 | CT |
N | 103TF0200X | Forensic Psychologist | 749 | CT |
NPI | 1609960327 |
---|---|
Provider Name | Dr. Michael Haymes |
First Address | Cromwell, CT 06416-2040 |
Second Address | Cromwell, CT 06416-2040 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 27/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
004008983 | (05) | CT |